Misoprostol-only versus mifepristone plus misoprostol in induction of labor following intrauterine fetal death. 2007

Wilma Väyrynen, and Oskari Heikinheimo, and Mika Nuutila
Department of Obstetrics and Gynecology, University of Helsinki, Finland.

BACKGROUND Both misoprostol-alone and a combination of mifepristone plus misoprostol have been used in induction of labor in cases of intrauterine fetal death (IUFD). METHODS Data from 130 women with IUFD at 21-42 weeks of gestation were analysed retrospectively. A total of 82 women received 100 microg (median) of misoprostol at 4-h intervals. Some 48 women received 200 mg of mifepristone, followed 19 h (median) later by single doses of 25 microg of misoprostol at 4-h intervals. RESULTS The induction-to-delivery time did not differ between the groups (13.3 versus 12.8 h). However, between 21 and 25 weeks of gestation, the induction-to-delivery time was shorter with the combination regimen (p=0.04). The total dose of misoprostol needed was lower in the group pre-treated with mifepristone (p=0.0028). The 2 groups did not differ as regards complications experienced during labor and delivery. CONCLUSIONS Both regimens, misoprostol-only and the combination of mifepristone and misoprostol, are effective and safe in induction of labor after IUFD. Pre-treatment with mifepristone is more effective at earlier gestational weeks.

UI MeSH Term Description Entries
D007751 Labor, Induced Artificially induced UTERINE CONTRACTION. Induced Labor,Induction of Labor,Labor Induced,Labor Induction,Induced, Labor,Induction, Labor,Inductions, Labor,Labor Inductions
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D005313 Fetal Death Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH. Fetal Mummification,Fetal Demise,Death, Fetal,Deaths, Fetal,Demise, Fetal,Fetal Deaths,Mummification, Fetal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000020 Abortifacient Agents, Nonsteroidal Non-steroidal chemical compounds with abortifacient activity. Abortifacient Agents, Non-Steroidal,Abortifacient Agents, Non Steroidal,Agents, Non-Steroidal Abortifacient,Agents, Nonsteroidal Abortifacient,Non-Steroidal Abortifacient Agents,Nonsteroidal Abortifacient Agents
D000021 Abortifacient Agents, Steroidal Steroidal compounds with abortifacient activity. Steroid Abortifacients,Abortifacients, Steroid,Agents, Steroidal Abortifacient,Steroidal Abortifacient Agents
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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